Provider Demographics
NPI:1023196003
Name:BARAN, DOLORES JENNY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOLORES
Middle Name:JENNY
Last Name:BARAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 N MAIN ST
Mailing Address - Street 2:STE A
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067
Mailing Address - Country:US
Mailing Address - Phone:248-548-1440
Mailing Address - Fax:248-548-3880
Practice Address - Street 1:1103 N MAIN ST
Practice Address - Street 2:STE A
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067
Practice Address - Country:US
Practice Address - Phone:248-548-1440
Practice Address - Fax:248-548-3880
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI150131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice